tbuckley/cabot-search huggingface dataset:
European Network for ICU-Related Respiratory Infections (ENIRRIs): a multinational, prospective, cohort study of nosocomial LRTI
Authors: Ignacio Martin-Loeches, Luis Felipe Reyes, Saad Nseir, Otavio Ranzani, Pedro Povoa, Emili Diaz, Marcus J Schultz, Alejandro H Rodríguez, Cristian C Serrano-Mayorga, Gennaro De Pascale, Paolo Navalesi, Mauro Panigada, Luis Miguel Coelho, Szymon Skoczynski, Mariano Esperatti, Andrea Cortegiani, Stefano Aliberti, Anselmo Caricato, Helmut J F Salzer, Adrian Ceccato, Rok Civljak, Paolo Maurizio Soave, Charles-Edouard Luyt, Pervin Korkmaz Ekren, Fernando Rios, Joan Ramon Masclans, Judith Marin, Silvia Iglesias-Moles, Stefano Nava, Davide Chiumello, Lieuwe D Bos, Antoni Artigas, Filipe Froes, David Grimaldi, Fabio Silvio Taccone, Massimo Antonelli, Antoni Torres
Journal: Intensive Care Medicine (2023)

Lower respiratory tract infections (LRTI) are the most frequent infectious complication in patients admitted to the intensive care unit (ICU). We aim to report the clinical characteristics of ICU-admitted patients due to nosocomial LRTI and to describe their microbiology and clinical outcomes.A prospective observational study was conducted in 13 countries over two continents from 9th May 2016 until 16th August 2019. Characteristics and outcomes of ventilator-associated pneumonia (VAP), ventilator-associated tracheobronchitis (VAT), ICU hospital-acquired pneumonia (ICU-HAP), HAP that required invasive ventilation (VHAP), and HAP in patients transferred to the ICU without invasive mechanical ventilation were collected. The clinical diagnosis and treatments were per clinical practice and not per protocol. Descriptive statistics were used to compare the study groups.1060 patients with LRTI (72.5% male sex, median age 64 [50-74] years) were included in the study; 160 (15.1%) developed VAT, 556 (52.5%) VAP, 98 (9.2%) ICU-HAP, 152 (14.3%) HAP, and 94 (8.9%) VHAP. Patients with VHAP had higher serum procalcitonin (PCT) and Sequential Organ Failure Assessment (SOFA) scores. Patients with VAP or VHAP developed acute kidney injury, acute respiratory distress syndrome, multiple organ failure, or septic shock more often. One thousand eight patients had microbiological samples, and 711 (70.5%) had etiological microbiology identified. The most common microorganisms were Pseudomonas aeruginosa (18.4%) and Klebsiella spp (14.4%). In 382 patients (36%), the causative pathogen shows some antimicrobial resistance pattern. ICU, hospital and 28-day mortality were 30.8%, 37.5% and 27.5%, respectively. Patients with VHAP had the highest ICU, in-hospital and 28-day mortality rates.VHAP patients presented the highest mortality among those admitted to the ICU. Multidrug-resistant pathogens frequently cause nosocomial LRTI in this multinational cohort study.
ChatGPT’s Responses to Dilemmas in Medical Ethics: The Devil is in the Details
Authors: Lukas J. Meier
Journal: The American Journal of Bioethics (2023)

Click to increase image sizeClick to decrease image sizeThis article refers to:What Should ChatGPT Mean for Bioethics?Ethics Education for Healthcare Professionals in the Era of ChatGPT and Other Large Language Models: Do We Still Need It? DISCLOSURE STATEMENTNo potential conflict of interest was reported by the author(s).Additional informationFundingThis work was supported by Churchill College, University of Cambridge.
Uncovering Hidden Racial and Ethnic Bias Through Electronic Health Record Logs
Authors: Lisa S. Rotenstein, Jose F. Figueroa
Journal: JAMA Network Open (2023)

Chao Yan, PhD; Xinmeng Zhang, BS; Yuyang Yang, BS; Kaidi Kang, MS; Martin C. Were, MD, MS; Peter Embí, MD, MS; Mayur B. Patel, MD, MPH; Bradley A. Malin, PhD; Abel N. Kho, MD; You Chen, PhD
OvaPrint—A Cell-free DNA Methylation Liquid Biopsy for the Risk Assessment of High-grade Serous Ovarian Cancer
Authors: David N. Buckley, Juan Pablo Lewinger, Gerald Gooden, Monique Spillman, Monica Neuman, X. Mona Guo, Ben Yi Tew, Heather Miller, Varun U. Khetan, Lee P. Shulman, Lynda Roman, Bodour Salhia
Journal: Clinical Cancer Research (2023)

Abstract Purpose: High-grade serous ovarian carcinoma (HGSOC) is the most lethal epithelial ovarian cancer (EOC) and is often diagnosed at late stage. In women with a known pelvic mass, surgery followed by pathologic assessment is the most reliable way to diagnose EOC and there are still no effective screening tools in asymptomatic women. In the current study, we developed a cell-free DNA (cfDNA) methylation liquid biopsy for the risk assessment of early-stage HGSOC. Experimental Design: We performed reduced representation bisulfite sequencing to identify differentially methylated regions (DMR) between HGSOC and normal ovarian and fallopian tube tissue. Next, we performed hybridization probe capture for 1,677 DMRs and constructed a classifier (OvaPrint) on an independent set of cfDNA samples to discriminate HGSOC from benign masses. We also analyzed a series of non-HGSOC EOC, including low-grade and borderline samples to assess the generalizability of OvaPrint. A total of 372 samples (tissue n = 59, plasma n = 313) were analyzed in this study. Results: OvaPrint achieved a positive predictive value of 95% and a negative predictive value of 88% for discriminating HGSOC from benign masses, surpassing other commercial tests. OvaPrint was less sensitive for non-HGSOC EOC, albeit it may have potential utility for identifying low-grade and borderline tumors with higher malignant potential. Conclusions: OvaPrint is a highly sensitive and specific test that can be used for the risk assessment of HGSOC in symptomatic women. Prospective studies are warranted to validate OvaPrint for HGSOC and further develop it for non-HGSOC EOC histotypes in both symptomatic and asymptomatic women with adnexal masses.
Why ChatGPT Means Communication Ethics Problems for Bioethics
Authors: Andrew J. Barnhart, Jo Ellen M. Barnhart, Kris Dierickx
Journal: The American Journal of Bioethics (2023)

Click to increase image sizeClick to decrease image sizeThis article refers to:What Should ChatGPT Mean for Bioethics? DISCLOSURE STATEMENTNo potential conflict of interest was reported by the author(s).Additional informationFundingThis work was supported by the European Union Horizon 2020 research and innovation program, OrganoVIR, under the Marie Skłodoska-Curie Actions grant agreement N. 812673.
Meaning by Courtesy: LLM-Generated Texts and the Illusion of Content
Authors: Gary Ostertag
Journal: The American Journal of Bioethics (2023)

Click to increase image sizeClick to decrease image sizeThis article refers to:AUTOGEN: A Personalized Large Language Model for Academic Enhancement—Ethics and Proof of Principle DISCLOSURE STATEMENTNo potential conflict of interest was reported by the author(s).Notes1 The phrase riffs on the title of Baker (Citation1987).2 Cappelen and Dever’s (Citation2021) example of an AI-generated credit score rating is helpful here. Lucie’s mortgage application is rejected, due to a credit score of 550. When she enquires into what this score means, and what it has to do with her credit-worthiness, she can at best get an answer that involves a mathematical description of input data and a description of how the data is processed through the successive layers of a neural network. But this is not satisfying to her: “How, she wonders, can a bunch of mathematical transformations, none of which in particular can be tied to any meaningful assessment of her credit-worthiness, somehow all add up to saying something about whether she should get a loan?” (2021: 9; emphasis added). Note that this does not dispute the accuracy of the rating algorithm. It only asks what it could mean for the score to have a semantic content – to be saying something about her credit worthiness – given the manner in which it was generated.3 See Nagel (Citation2014, Chapter 6) for a discussion.Additional informationFundingThe author(s) reported there is no funding associated with the work featured in this article.
Estimates of Major Depressive Disorder and Treatment Among Adolescents by Race and Ethnicity
Authors: Michael William Flores, Amanda Sharp, Nicholas J. Carson, Benjamin L. Cook
Journal: JAMA Pediatrics (2023)

The COVID-19 pandemic has contributed to poorer mental health and a greater need for treatment. Nationally representative estimates of major depressive disorder (MDD) and mental health treatment among US adolescents during the pandemic are needed.
Metal ureteral stents for ureteral stricture: 2 years of experience with 246 cases
Authors: Xiaoshuai Gao, Xingpeng Di, Guo Chen, Wei Wang, Liao Peng, Jixiang Chen, Xin Wei
Journal: International Journal of Surgery (2023)

Background: Metal ureteral stents (MUS) has gained popularity as an endoscopic treatment alternative for the management of ureteral strictures. The aim of this study was to evaluate the safety, efficacy, and tolerability of MUS for treating ureteral strictures and to identify any factors that could influence the success of this intervention. Methods: This study is a prospective analysis of the efficacy and safety of MUS for treating ureteral strictures in a single-center setting. The study enrolled 246 patients who had been diagnosed with ureteral strictures and had undergone MUS placement between January 2019 and July 2021. The patients were followed up for a duration of 2 years. Results: The overall success rate of MUS placement was 71.7%. Furthermore, the success rate of ureteral strictures after kidney transplantation (78.2%) was significantly higher than common ureteral strictures (73.0%) or recurrent ureteral strictures (67.6%). Additionally, post-surgery, there was a considerable reduction in hydronephrosis volume (68.9±96.1 vs. 32.1±48.8 cm3), blood creatinine level (103.7±49.8 vs. 94.4±47.5 mol/L) and urea nitrogen level (6.7±7.2 vs. 5.1±2.4 mmol/L). The study also reported that the rate of adverse events associated with MUS was relatively low, included hematuria (7.9%), pain (6.8%), urinary tract infection (6.4%) and lower urinary tract symptoms (5.3%). Conclusion: MUS appear to be a safe and effective treatment option for ureteral strictures, with a high success rate and low complication rate. These results have important implications for the management of ureteral strictures and can help guide clinical decision-making in the selection of treatment options.
The Ouroboros Threat
Authors: Joseph Michael Vukov, Tera Lynn Joseph, Gina Lebkuecher, Michelle Ramirez, Michael B. Burns
Journal: The American Journal of Bioethics (2023)

Click to increase image sizeClick to decrease image sizeThis article refers to:What Should ChatGPT Mean for Bioethics?Ethics Education for Healthcare Professionals in the Era of ChatGPT and Other Large Language Models: Do We Still Need It? DISCLOSURE STATEMENTNo potential conflict of interest was reported by the author(s).Additional informationFundingThe author(s) reported there is no funding associated with the work featured in this article.
Letter to the Editor: Acute rejection after liver transplantation with machine perfusion versus static cold storage: A systematic review and meta-analysis
Authors: Gang Tang, Linyu Zhang, Rongxing Zhou
Journal: Hepatology (2023)

1Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China 2Center for Translational Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China Correspondence Rongxing Zhou; Address: No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, P.R. China. Email: [email protected]
Self-reported symptoms experienced by intensive care unit patients: a prospective observational multicenter study
Authors: Christin Saltnes-Lillegård, Tone Rustøen, Sigrid Beitland, Kathleen Puntillo, Milada Hagen, Anners Lerdal, Kristin Hofsø
Journal: Intensive Care Medicine (2023)

The purpose of this study is to describe the prevalence, intensity and distress of five symptoms in intensive care unit (ICU) patients and to investigate possible predictive factors associated with symptom intensity.This is a prospective cohort study of ICU patients. A symptom questionnaire (i.e., Patient Symptom Survey) was used to describe the prevalence, intensity and distress of pain, thirst, anxiousness, tiredness, and shortness of breath over seven ICU days. Associations between symptom intensity and possible predictive factors were assessed using the general estimating equation (GEE) model.Out of 603 eligible patients, 353 (Sample 2) were included in the present study. On the first ICU day, 195 patients (Sample 1) reported thirst as the most prevalent symptom (66%), with the highest mean intensity score (6.13, 95% confidence interval (CI) [5.7-6.56]). Thirst was the most prevalent (64%) and most intense (mean score 6.05, 95%CI [5.81-6.3]) symptom during seven days in the ICU. Anxiousness was the most distressful (mean score 5.24, 95%CI [4.32-6.15]) symptom on the first day and during seven days (mean score 5.46, 95%CI [4.95-5.98]). During seven days, analgesic administration and sepsis diagnosis were associated with increased thirst intensity. Older age and being mechanically ventilated were associated with decreased pain intensity, and analgesic administration was associated with increased pain intensity. Family visits and female gender were associated with increased intensity of anxiousness and shortness of breath, respectively.Self-reporting ICU patients experienced a high and consistent symptom burden across seven days. Certain variables were associated with the degree of symptom intensity, but further research is required to better understand these associations.
Reply: Outbreak of indeterminate acute hepatitis in children, not a new disease but an epidemiological phenomenon
Authors: Randa Elsheikh, Abdelrahman M. Makram, Nguyen Tien Huy
Journal: Hepatology (2023)

1Deanery of Biomedical Sciences, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom 2Online Research Club (www.onlineresearchclub.org), Nagasaki, Japan 3School of Public Health, Imperial College London, London, United Kingdom 4School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan Abbreviations: IAH, Indeterminate acute hepatitis; PALF, Pediatric acute liver failure; SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2 Correspondence Nguyen Tien Huy, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan. Email: [email protected] Correspondence Randa Elsheikh, Faculty of Medicine, October 6 University, Giza, Egypt. Email: [email protected]
ERS/ESTS/ESTRO/ESR/ESTI/EFOMP statement on management of incidental findings from low dose CT screening for lung cancer
Authors: Emma L. O'Dowd, Ilona Tietzova, Emily Bartlett, Anand Devaraj, Jürgen Biederer, Marco Brambilla, Alessandro Brunelli, Joanna Chorostowska-Wynimko, Herbert Decaluwe, Dirk De Ruysscher, Walter De Wever, Matthew Donoghue, Aurelie Fabre, Mina Gaga, Wouter van Geffen, Georgia Hardavella, Hans-Ulrich Kauczor, Anna Kerpel-Fronius, Jan van Meerbeeck, Blin Nagavci, Ursula Nestle, Nuria Novoa, Helmut Prosch, Mathias Prokop, Paul Martin Putora, Janette Rawlinson, Marie-Pierre Revel, Annemiek Snoeckx, Giulia Veronesi, Rozemarijn Vliegenthart, Sabine Weckbach, Torsten G. Blum, David R. Baldwin
Journal: European Respiratory Journal (2023)

Screening for lung cancer with low radiation dose computed tomography has a strong evidence base, is being introduced in several European countries and is recommended as a new targeted cancer screening programme. The imperative now is to ensure that implementation follows an evidence-based process that will ensure clinical and cost effectiveness. This European Respiratory Society (ERS) task force was formed to provide an expert consensus for the management of incidental findings which can be adapted and followed during implementation.
Amyloid Positron Emission Tomography and Subsequent Health Care Use Among Medicare Beneficiaries With Mild Cognitive Impairment or Dementia
Authors: Gil D. Rabinovici, Maria C. Carrillo, Charles Apgar, Ilana F. Gareen, Roee Gutman, Lucy Hanna, Bruce E. Hillner, Andrew March, Justin Romanoff, Barry A. Siegel, Karen Smith, Yunjie Song, Christopher Weber, Rachel A. Whitmer, Constantine Gatsonis
Journal: JAMA Neurology (2023)

Results of amyloid positron emission tomography (PET) have been shown to change the management of patients with mild cognitive impairment (MCI) or dementia who meet Appropriate Use Criteria (AUC). To determine if amyloid PET is associated with reduced hospitalizations and emergency department (ED) visits over 12 months in patients with MCI or dementia. This nonrandomized controlled trial analyzed participants in the Imaging Dementia-Evidence for Amyloid Scanning (IDEAS) study, an open-label, multisite, longitudinal study that enrolled participants between February 2016 and December 2017 and followed up through December 2018. These participants were recruited at 595 clinical sites that provide specialty memory care across the US. Eligible participants were Medicare beneficiaries 65 years or older with a diagnosis of MCI or dementia within the past 24 months who met published AUC for amyloid PET. Each IDEAS study participant was matched to a control Medicare beneficiary who had not undergone amyloid PET. Data analysis was conducted on December 13, 2022. Participants underwent amyloid PET at imaging centers. The primary end points were the proportions of patients with 12-month inpatient hospital admissions and ED visits. One of 4 secondary end points was the rate of hospitalizations and rate of ED visits in participants with positive vs negative amyloid PET results. Health care use was ascertained from Medicare claims data. The 2 cohorts (IDEAS study participants and controls) each comprised 12 684 adults, including 6467 females (51.0%) with a median (IQR) age of 77 (73-81) years. Over 12 months, 24.0% of the IDEAS study participants were hospitalized, compared with 25.1% of the matched control cohort, for a relative reduction of -4.49% (97.5% CI, -9.09% to 0.34%). The 12-month ED visit rates were nearly identical between the 2 cohorts (44.8% in both IDEAS study and control cohorts) for a relative reduction of -0.12% (97.5% CI, -3.19% to 3.05%). Both outcomes fell short of the prespecified effect size of 10% or greater relative reduction. Overall, 1467 of 6848 participants (21.4%) with positive amyloid PET scans were hospitalized within 12 months compared with 1081 of 4209 participants (25.7%) with negative amyloid PET scans (adjusted odds ratio, 0.83; 95% CI, 0.78-0.89). Results of this nonrandomized controlled trial showed that use of amyloid PET was not associated with a significant reduction in 12-month hospitalizations or ED visits. Rates of hospitalization were lower in patients with positive vs negative amyloid PET results.
ChatGPT’s Relevance for Bioethics: A Novel Challenge to the Intrinsically Relational, Critical, and Reason-Giving Aspect of Healthcare
Authors: Ramón Alvarado, Nicolae Morar
Journal: The American Journal of Bioethics (2023)

Click to increase image sizeClick to decrease image sizeThis article refers to:What Should ChatGPT Mean for Bioethics? DISCLOSURE STATEMENTNo potential conflict of interest was reported by the author(s).Additional informationFundingThe author(s) reported there is no funding associated with the work featured in this article.
Validity and Utility of a Hierarchical Composite End Point for Clinical Trials of Kidney Disease Progression: A Review
Authors: Dustin J. Little, Samvel B. Gasparyan, Patrick Schloemer, Niels Jongs, Meike Brinker, Martin Karpefors, Christoph Tasto, Nicole Rethemeier, Lars Frison, Richard Nkulikiyinka, Jerome Rossert, Hiddo J.L. Heerspink
Journal: Journal of the American Society of Nephrology (2023)

Clinical trials in nephrology often use composite end points comprising clinical events, such as onset of ESKD and initiation of kidney function replacement therapy, along with a sustained large ( e.g. , ≥50%) decrease in GFR. Such events typically occur late in the disease course, resulting in large trials in which most participants do not contribute clinical events. In addition, components of the end point are considered of equal importance; however, their clinical significance varies. For example, kidney function replacement therapy initiation is likely to be clinically more meaningful than GFR decline of ≥50%. By contrast, hierarchical composite end points (HCEs) combine multiple outcomes and prioritize each patient's most clinically relevant outcome for inclusion in analysis. In this review, we consider the use of HCEs in clinical trials of CKD progression, emphasizing the potential to combine dichotomous clinical events such as those typically used in CKD progression trials, with the continuous variable of GFR over time, while ranking all components according to clinical significance. We consider maraca plots to visualize overall treatment effects and the contributions of individual components, discuss the application of win odds in kidney HCE trials, and review general design considerations for clinical trials for CKD progression with kidney HCE as an efficacy end point.
4‐Axis 3D‐Printed Tubular Biomaterials Imitating the Anisotropic Nanofiber Orientation of Porcine Aortae
Authors: Florian Lackner, Paola Šurina, Julia Fink, Petra Kotzbeck, Dagmar Kolb, Jan Stana, Maximilian Grab, Christian Hagl, Nikolaos Tsilimparis, Tamilselvan Mohan, Karin Stana Kleinschek, Rupert Kargl
Journal: Advanced Healthcare Materials (2023)

Abstract Many of the peculiar properties of the vasculature are related to the arrangement of anisotropic proteinaceous fibers in vessel walls. Understanding and imitating these arrangements can potentially lead to new therapies for cardiovascular diseases. These can be pre‐surgical planning, for which patient‐specific ex vivo anatomical models for endograft testing are of interest. Alternatively, therapies can be based on tissue engineering, for which degradable in vitro cell growth substrates are used to culture replacement parts. In both cases, materials are desirable that imitate the biophysical properties of vessels, including their tubular shapes and compliance. This work contributes to these demands by offering methods for the manufacturing of anisotropic 3D‐printed nanofibrous tubular structures that have similar biophysical properties as porcine aortae, that are biocompatible, and that allow for controlled nutrient diffusion. Tubes of various sizes with axial, radial, or alternating nanofiber orientation along the blood flow direction are manufactured by a customized method. Blood pressure‐resistant, compliant, stable, and cell culture‐compatible structures are obtained, that can be degraded in vitro on demand. It is suggested that these healthcare materials can contribute to the next generation of cardiovascular therapies of ex vivo pre‐surgical planning or in vitro cell culture.
Unreliable LLM Bioethics Assistants: Ethical and Pedagogical Risks
Authors: Lea Goetz, Markus Trengove, Artem Trotsyuk, Carole A. Federico
Journal: The American Journal of Bioethics (2023)

Click to increase image sizeClick to decrease image sizeThis article refers to:Ethics Education for Healthcare Professionals in the Era of ChatGPT and Other Large Language Models: Do We Still Need It?This article is referred to by:Generative-AI-Generated Challenges for Health Data Research DISCLOSURE STATEMENTMarkus Trengove and Lea Goetz are both permanent employees of GSK. Artem Trostyuk and Carole A. Federico are both GSK.ai fellows.Notes1 Full transcripts of exchange available upon request from corresponding author.Additional informationFundingThe author(s) reported there is no funding associated with the work featured in this article.
Ethical Vaccine Recommendations in the Context of Tenuous Data: Honesty is the Best Policy
Authors: Ross McKinney
Journal: The American Journal of Bioethics (2023)

Click to increase image sizeClick to decrease image sizeThis article refers to:Researcher Obligations to Participants in Novel COVID-19 Vaccine Research DISCLOSURE STATEMENTDr. McKinney has no conflicts of interest to declare.Additional informationFundingThe author(s) reported there is no funding associated with the work featured in this article.